<%@ taglib uri="http://java.sun.com/jsp/jstl/core" prefix="c"%>
<%@taglib prefix="form" uri="http://www.springframework.org/tags/form"%>
<div id="content_main">
	<form:form method="post" action="/ChitFund/user/saveMember.htm">
		<div id="content_form">
			<div id="error"></div>
			<div id=member_info>
				<fieldset>
					<legend>
						<strong>Member Information</strong>
					</legend>
					<table>
						<tr>
							<td><strong><label>Form No.</label></strong></td>
							<td><form:input path="formNo" id="formNo" /></td>
							<td><strong><label>Member Id</label></strong></td>
							<td><form:input path="memberId" id="memberId" /></td>
						</tr>
						<tr>
							<td><form:label path="branch.branchId">Branch</form:label></td>
							<td><select name="branch.branchId">
									<option selected="selected" value="null">select Branch</option>
									<c:forEach var="branch" items="${branches}">
										<option value="${branch.branchId}">
											<c:out value="${branch.branchName}" />
										</option>
									</c:forEach>
							</select></td>
						</tr>
						<tr>
							<td><strong><label>Bank Account No.</label></strong></td>
							<td><form:input path="bankAccNo" id="bankAccNo" /></td>
							<td><strong><label>Ticket No. </label></strong></td>
							<td><form:input path="ticketNo" id="ticketNo" /></td>
						</tr>
						<tr>
							<td><strong><label>Name </label></strong></td>
							<td><form:input path="firstName" id="firstname" /></td>
							<td><form:input path="middleName" id="middleName" /></td>
							<td><form:input path="lastName" id="lastName" /></td>
						</tr>
						<tr>
							<td><strong><label>Current Address</label></strong></td>
							<td><textarea name="currentAddress" cols="17" rows="1"
									id="currentAddress"></textarea></td>
							<td><strong><label>Permanent Address</label></strong></td>
							<td><textarea name="perAddress" cols="17" rows="1"
									id="perAddress"></textarea></td>
						</tr>
						<tr>
							<td><strong><label>Mobile No. </label></strong></td>
							<td><form:input path="mobileNo" id="mobileNo" /></td>
							<td><strong><label>Gender</label></strong></td>
							<td><form:input path="gender" id="gender" /></td>
						</tr>
						<tr>
							<td><strong><label>Phone No. </label></strong></td>
							<td><form:input path="phoneNo" id="phoneNo" /></td>
							<td><strong><label>BirthDate</label></strong></td>
							<td><form:input path="birthDate" id="birthDate"></form:input></td>
						</tr>
						<tr>
							<td><strong><label>Join Date </label></strong></td>
							<td><form:input path="joinDate" id="joinDate"
									onBlur="getAge()" /></td>
							<td><form:label path="agent.agentId">Agent Name</form:label></td>
							<td><select name="agent.agentId">
									<option selected="selected" value="null">select Agent</option>
									<c:forEach var="agent" items="${agents}">
										<option value="${agent.agentId}">
											<c:out value="${agent.agentName}" />
										</option>
									</c:forEach>
							</select></td>

						</tr>
						<tr>
							<td><form:label path="group.groupId">Group Name</form:label></td>
							<td><select name="group.groupId">
									<option selected="selected" value="null">select Group</option>
									<c:forEach var="group" items="${groups}">
										<option value="${group.groupId}">
											<c:out value="${group.groupName}" />
										</option>
									</c:forEach>
							</select></td>
							<td><strong><label>Is Liable</label></strong></td>
							<td><select name="isliable" id="isliable">
									<option>TRUE</option>
									<option>FALSE</option>
							</select></td>
						</tr>
						<tr>
							<td><strong><label>Reference ID</label></strong></td>
							<td><select name="reference_id" id="reference_id">
									<option>Select</option>
							</select></td>
						</tr>

					</table>
					<div class="form-btn">
						<input name="Save" id="save" type="submit" value="Save"
							onClick="getAge()" class="btn btn-large"> <input
							name="Clear" id="clear" type="reset" value="Clear"
							class="btn btn-large">
					</div>
				</fieldset>
			</div>
		</div>
		<div id="nominee_info">
			<fieldset>
				<legend>
					<strong>Nominee Information</strong>
				</legend>
				<table>
					<tr>
						<td><strong><label>Nominee Name</label></strong></td>
						<td><form:input path="nominee" id="nominee" /></td>
					</tr>
					<tr>
						<td><strong><label>Noninee Ph.No.</label></strong></td>
						<td><form:input path="nominee_phno" id="nominee_phno" /></td>
					</tr>
					<tr>
						<td><strong><label>Nominee BirthDate</label></strong></td>
						<td><form:input path="nominee_birth" id="nominee_birth" /></td>
					</tr>
					<tr>
						<td><strong><label>Client Relation</label> </strong></td>
						<td><form:input path="rel_client" id="rel_client" /></td>
					</tr>
				</table>
			</fieldset>
		</div>
	</form:form>
</div>